The Impact of a Physiotherapist in the Role of Clinical Matron within a Stroke Service

Purpose

To explore the impact of putting senior clinicians at the bedside with clinical expertise in their speciality to improve quality of patient care. This role was introduced at Hampshire Hospitals Foundation Trust (HHFT) in 2016, whilst mainly undertaken by senior nurses, 2 physiotherapists and an occupational therapist have also undertaken the role. This presentation explores the impact of physiotherapists undertaking such roles.

Approach

A specialist Physiotherapist was recruited as Clinical Matron at Band 8a level. The Matron is ward based and 80% of time is spent clinically utilising expert knowledge in stroke care. Administrative support was provided to all matrons to enable them to remain clinical. An ongoing training programme was established to develop expert managerial and leadership skills.

Clinical Matrons were actively encouraged to have autonomy for their wards and given full budgetary control.

Outcomes

The Physiotherapist in the Clinical Matron role has led to the following outcomes A reduction in formal complaints of 75% over a 1 year period. Statutory and Mandatory training has increased to 92% Patient satisfaction via friends and family test has been maintained at 97% despite the ward being considerably busier with a 36% increase in the number of admissions. Reduction of 50% in the number of falls resulting in harm Creative recruitment to traditional nursing roles; A physiotherapist and a paramedic have become stroke co-ordinators, facilitating hyper-acute stroke care from the Emergency Department

Implications

The role of a specialist physiotherapist in the Clinical Matron role has led to a different style and approach to ward management. A true understanding of the 24 hour rehabilitation process has led to more efficient discharge planning and there is a culture open to challenge which optimises the patient journey.

A physiotherapist has the ability to assess and treatment plan immediately from point of admission for stroke patients, this shapes and guides rehabilitation goals and length of stay. With a physiotherapy background specialising in neurology this role brings a wealth of experience in stroke care.

The physiotherapist as Clinical Matron proactively empowers patients, promoting ownership of rehabilitation and positively influence the rehab mind set of the MDT. The Clinical Matron role provides a unique opportunity to managerially progress and have involvement at a senior level within the organisation whilst continuing to work directly alongside the patients. This role has enabled a senior physiotherapist to develop the unit and proactively drive the stroke service forward.

This offers an alternative route of career progression at senior level within physiotherapy. Furthermore it put physiotherapists at the forefront of senior leadership within the hospital setting.

Fund acknowledgements

This work was unfunded.

Additional notes

This work was presented at Physiotherapy UK 2018.